Form 5500 · Employee benefit plan · HARTFORD, CT
MAX HOSPITALITY, LLC
The filing calls this plan MAX HOSPITALITY, LLC EMPLOYEE BENEFIT PLAN.
MAX HOSPITALITY, LLC of HARTFORD, CT files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is ACRISURE LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 87-3600947 · plan 501 · plan year 2025, filed Jul 23, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 1 insured contract covering health and vision; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 116 people.
Reported premium is $786,970; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | Health, Vision | 116 | Jan 1, 2026 | $786,970 | $0 |
Premium and claims on this contract
CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 00638306. For the contract year on this filing, the carrier reported $786,970 in premium earned and $500,694 in claims incurred. Dividing one by the other gives 64%.
- CIGNA HEALTH AND LIFE INSURANCE COMPANY, contract 00638306 reported $89,000 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Other plans filed by this employer
How this plan compares
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